Wichita eagle. [volume] (Wichita, Kan.) 1886-1890, 1887-10-16
CARELESS DOCTORS.
CRIMlNAllY SERIOUS SLIPS MADE
IN WRiTl1G PRESCRIPTIONS.

Medicines-How Mistakes Frequently
Occur-Another Evil.
How often do we hear of a fatal error n>ade
by some sleepy or negligent druggists clerk,
compounding morphine for quinine, laud-
anum for paregoric or oxalic acid for EPSON
| salts. How seldom do we hear of the criminal
carelessness or murderous errors made by
physicians themselves in writing their pre-
scriptions I am satisfied, after careful e1-
animation, that the latter exceed the former
ten to one, and that the services of the
coroner are not oftener required is due alone
to fact notorious i'll the profession, that
a competent druggist carefully studies every
prescription calling for powerful drugs, and
himself corrects the doctors mistakes. One
serious error by druggist winds up his BUSH
ness in rapid order. There is no one to stand
between the incompetent druggist and his vic
tim, but the careless doctor can depend with
reasonable assurance upon the strong prob
ability that if his figures are wrong and the
dose Of the drug is double what it should be,
the pharmacists trained eye will detect the
slip or the ignorance and put in the right
quantity.
l asked a prominent druggist the other day
if he often had to correct prescriptions. He
smiled. Il never correct a physicians pre-
scription," he replied. "My business is phar-
macy, not medicine"
"But in case you got an order calling for
ten grains of strychnine, to be taken at
oncei"
Il would not fill it. l would send it back
to the physician with polite note of inquiry.
That would be the retort courteous"
"Do you examine all prescriptions you
compound with view to possible errors?"
Certainly. Every druggist is compelled
to do that in self protection. For example,
here is prescription sent here a few weeks
ago.
"Now this, as you see, called for twenty
pills OF sulphate of morphine, gelatine coated,
each to contain two grains"
"Did you refuse it?"
"No, filled it-and there was no funeral
followed. gave ten two-grain pills Of sui
phate of quinine, gelatine coated, for / knew
that to be what the physician intended to
prescribe. He is getting little old now and
sometimes makes slip of that kind, but we
always manage to set it right. About four
months ago one of my clerks brought me a
prescription calling for one gramme of BIZ
chloride of mercury, or corrosive sublimate,
X
which would have made the dose two grains
in each pili-enough to kill an elephant.
sent the prescription to the physician. He
erased gramme and wrote grain, even then
prescribing the maximum dose of the drug
one-eighth of a grain"
"Could not gramme be easily mistaken for
graing"
"Most easily. Gramme is usually abbrevi-
ated thus, 'gm.,' while grain is .'gr.' Many
physicians use the metric system, and specify
the weight in grammes Now, if only one
drug is ordered the sign 'gm' may easily be
read 'gr., and the patient will get only one
sixteenth of the amount intended, or, vice
versa, he may get sixteen times too much
The latter case is not so probable, for the
druggists knowledge of doses would inter-
fere. But such q prescription falling into
the hands of an ignorant clerk could easily
furnish business for the undertaken and no
one be the WISER"
"How often is the judgment of the druggist
called into play over such questions?"
with us it is matter of almost daily oc-
currence, but of course we handle large
number of prescriptions. Most of the puzzles
are due to the wretched handwriting affected
by some doctors"
l asked another leading uptown druggist
concerning his experience with errors in pre-
scriptions.
'They have numbered hundreds he said,
"bnt as we invariably refer them back when
illeGible or calling for more than the maxi
mum dose given in the dispensatory the con-
sequence does not fall upon the patient"
allow do the doctors behave when advised
of their mistakesE
"Some take it kindly; others try to bluff
the case through by saying that heroic doses
were required; Others get angry. ] sent one
prescription back to an eminent professor in
this city. 1t called for half grain of strych-
nine to the dose. He tore it up, withdrew
his patronage and wrote us an indignant let
ter, claiming that the prescription called for
only LIS of grain. He had destroyed our
evidence and there the matter ended. One
night l got a prescription calling for 100
grains of iodide of potassium in three pow
ders, one to be taken every four hours. The
regular dose Of iodide is from five TO ten
grains. l sent messenger to inquire, and
the reply was the erasure of 'iodide and the
substitution of bromide The least conse-
quence of the iodide would have been furi-
Gus eruption all over the patient, to which
entitled him, as he was suffering from de-
hriun tremens"
@Do you have much trouble with quacks3r
GNo. Quacks usually give very simple and
harmless remedies. They know their incom-
petence and constantly fear arrest for NAL
practice should an accident occur. The
quack, as q rule, confines himself to light
cathartics, tonics and lotions, giving childs
doe to an adult and trusting to luck and ma
ture to effect cure Most of them compound
their own nostrunls and thus make double
profit, besides avoiding the placing of their
errors on record. 1t is the regular physician
and the physician of high standing who is
most apt to be careless
Another evil TO which my attention was
called is the habit of some physicians instead
Of specifying the dose and the time for its
repetition, TO give Simply this general order:
ITO be used as directed" Perhaps several
medicines have been ordered. The invalid
may Se in charge of an ignorant or forgetful
nurse to whom this gives discretionary pow
ers which may easily become fatal / saw
myself q prescription calling for Majendie's
solution of morpaia and marked III this way
Was not this criminal carelessnessl
Medicines are often kept in the household
after the illness for which they were pre-
scribed has terminated The direction of the
physician has loSg since been forgotten
Another member of the family, perhaps G
child, is taken down with some petty COM
plant, and the qGondam patient prescribrs
dose of the remedy used in his own case.
How much shall be givel he looks AZ the bot
tie: Use as directed" He thinks ne remeun-
bers having taken tablespoonful, 50 lie ad-